How Young is Too Young? Part 1: Prescribing Psychiatric Drugs – Infancy to Toddlerhood

Michael W. Corrigan, EdD
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Do you remember feeling pressure as a child to do better at school, fit in socially, or behave more appropriately? Making the right decision was not always as easy as adults and cheerful children’s books sometimes painted it. Luckily, stumbling slow motion through a decade or so of dysfunctional days (aka natural childhood development) was an expected and accepted part of growing up. Today’s expectations and demands placed on children for Disney-like perfection, however, are exponentially greater and strangely different.

At an ever increasingly early age, we are expecting kids to behave years beyond their developmental ability and maturation. For those who do not meet such expectations (e.g., See Dick Bite Jane), the consequences are futuristically surreal. The quip “take a pill” which was used figuratively not too long ago, now literally has become a daily mantra for millions of kids. So how young is too young to place such pressure and push psychiatric drugs on our youth?

Under Pressure

Despite life rarely providing a magic wand to fix anything quickly, parents are being told there is  supposedly an easier more efficient way to get children to behave appropriately and improve academically. Instinctively, such promises of grandeur immediately sound off warning bells in our brains. We know that hard work and patience will be required regardless, but the temptation to possibly bypass a large amount of trials and tribulations is sometimes too hard to fight. Conventional parenting wisdom whispering “this too shall pass,” is silenced.

As a result, many exhausted parents are accepting supposed claims that a serious mental disorder label combined with a magic pill is a safe alternative to help children with their developmental behavior challenges. Many see immediate changes in behavior but fail to read research that explains such “improvements” are the result of the child’s brain being medicated to malfunction. Many dismiss a laundry list of dangerous side effects listed in the medication guides, and take the risk that suicidal ideation, permanent facial tics and more severe mental disorders won’t be the case for their child.

Unfortunately, many also are unaware of or ignoring research which shows natural child development is a sequential and painfully slow gradual process. A process that cannot and should not be rushed. Decades of developmental theory and research confirm, and many grandparents will agree, kids have displayed the behaviors associated with today’s most popular mental disorders for quite some time. And prior to a few decades ago, we rarely drugged them.

So take a big gulp of that triple gargantuan vanilla latte or monstrous 45-hour energy drink, because I am about to share an extended release dose of … cue the Barry White music … “oh yeah baby” … “mmmm-uhhhh” … “I can’t get enough of ” … child development theory!

Eight Million “Wrong,” and Growing

In a recent blog, I wrote about the mind-bottling number of kids prescribed psychiatric drugs. More than eight million children, from infants to teenagers, are prescribed potentially life-threatening pharmaceuticals for mental disorders such as ADHD, anxiety, bipolar and depression. The possibility exists, however, that a large percentage, in the prime of their developmental learning curves,  are being labeled and drugged for displaying common developmental challenges.

As the brief summary of child development theory and research to follow illuminates, decades of sound theory-driven replicated studies document that such behaviors typically and naturally mellow with time as children progress through sequential stages, and mature. Just because your child (when compared to others) possibly displays more frequent, stronger or longer mood swings related to anger, anxiety, depression, happiness or hyperactivity, that does not mean they will behave this way forever, or that such behavior is abnormal. In fact, expressions of anger typically increase in frequency and intensity from four months old into the second year (Braungart et al., 2010).

Displaying extreme behaviors is not necessarily a bad thing. Albert Einstein displayed anger issues throughout childhood and didn’t speak until four or five years of age. In many cases, when these behaviors (e.g., argumentativeness, extroversion) are managed and harnessed by the child, they define one’s unique individual personality type and future career skills. Such behaviors, when strategically complemented by more inspiring parenting and instruction, are what feed our artistic and creative talents, leadership abilities, and communicative proficiency. As many parents have learned; though rather frustrating in the early years, such behaviors were signs of giftedness, and not a disorder.

Of course, these somewhat bothersome behaviors can be extremely frustrating. Common childhood challenges are quite capable of driving the vast majority of us parents and educators across the border to Bonkersville. There is no doubt that many parents and educators need more support and possibly training. Some children truly do need mental health therapy for maladaptive levels of such behaviors possibly related to issues such as trauma. But semi-annoying behaviors which once were accepted as part of childhood and parenthood, are now feeding a billion dollar child-focused appendage of the pharmaceutical industry.

Too Soon?

From the attention given to my latest blog on this mind-bottling movement to drug kids (Thank you for sharing, BTW!), I guess the astronomical number of children on psychiatric drugs also left many others with a similar chronic case of cognitive dissonance and numerophobia. Personally, my mind was blown when I read that 509,891 children three or younger are on anti-anxiety pills. Apparently most troubling to many adults is that more than a million of these eight million plus kids are five or younger, and 274,804 are a year old or less. When it comes to accepting such practices to drug kids for mental disorders, many seem to draw the line at around 3 years of age and even more are appalled when it comes to drugging infants.

I am a parent of two wonderful yet highly over-energetic and opinionated children, who — let’s say — often display unpredictable levels of neuroticism. As a psychologist who teaches child development, I truly cannot fathom how we actually have reached this point of drugging more than eight million kids. Besides the billions of dollars put annually into marketing these drugs, which is not even proportionately close to their investments researching the safety or long term effects of the drugs, how have so many, so young, become repeat customers to those with a license to pill? Common sense and non-pharmaceutical funded scientific research on the natural child development process can provide a much better explanation for the behaviors too often used as symptoms to justify a mental health diagnosis and drug kids.

For example, Jean Piaget’s theory of cognitive development categorizes the first stages spanning infancy and toddlerhood as Sensorimotor and Preoperational. Piaget’s research shows that during this time kids think by acting on the world with their eyes, ears, hands and mouth. During these early stages of critical development where minimal logic is applied to decision making, kids are trying to use limited symbols, not even words necessarily, to solve problems. According to Menyuk, Liebergott and Schultz, a five-month lag exists between the time toddlers typically comprehend 50 words (around 13 months) and the time they produce as many words (around 18 months). How can an ethical doctor even legitimize drugging a child who has not learned to complete a sentence?

Lawrence Kohlberg’s moral development theory calls this period a time of preconventional morality. Kids at this stage typically only make moral decisions as a means to avoid punishment or exchange favors to get what they want. As Albert Bandura’s social learning theory shows us, infants and toddlers are often left to just imitate and model the behaviors of others they have witnessed. From a somewhat more unusual perspective, according to Sigmund Freud such kids are only interested in sucking on breasts and bottles, holding and releasing urine and feces, and seeking pleasure through genital stimulation. He called these stages oral, anal and phallic. As they say down south, “bless his heart.”

The point is that infants and toddlers are not yet at the operational stage to grasp the conventional behaviors society desires and expects. There are many more theories that can be applied to better explaining why kids act like kids. These theories provide a lens to view what kids are thinking about, where they are coming from. Kids from infancy to toddlerhood are not that focused on what some adults wish they were focused on. Instead of showing they have mastered acceptable behavior, they are experimenting everyday and stumbling slowly through this thing we call life.

It’s a Wild, Neuronic Ride

As many parents will attest, the ups and downs of childhood development are similar to a rollercoaster. When it comes to infancy and toddlerhood, this is the early portion of the ride where one is coming out of the steepest incline screaming like a small child and corkscrewing uncontrollably toward nausea at warp speed.  As theorists have suggested for more than a century and today’s neuroscience confirms, the first few years of life are when our children’s brains are developing faster than we will ever see again.

Supporting this early childhood cognitive and emotional development is essential to constructing the foundational building blocks needed to program billions of neurons. Feeding these neurons with nutrition, structure, love and diverse sensory is critical to helping children learn to build on their knowledge and behave appropriately for years to come. Not providing these essential ingredients can lead to critical neurons being pruned from their brains, and thus resulting in temporary or possibly permanent developmental delays. Assuming that a mind-altering pill, which is hypothesized to unnaturally manage a supposed imbalance of neurochemicals, can aid in such natural development and increase rational behavior, just seems shortsighted at best.

We have all seen infants and toddlers behave in ways that society frowns upon and heard them scream at migraine-inducing levels. As nearly every book on child development will concur, temper tantrums, lack of moral compass, and being distracted by every miniscule piece of sensory input that touches one of their five senses, are just a few behaviors reflecting the cognitive and emotional challenges of infancy and toddlerhood. Nearly every day in the life of all infants and toddlers includes numerous moments of inattention, hyperactivity, anxiety, and mini-manic episodes of happiness, depression and anger.

Instantaneously they can go from delighted to anxiety-ridden when a toy is taken away. Screaming, crying and displaying other slightly bothersome behaviors are what they have seen others do at daycare. It’s what has worked to get parents to their crib-side or feed them for months on end. When we see children repetitively react in certain ways that might seem less than appropriate or troublesome, we must understand these actions are just a tiny part of the arduous time travel experiment we call child development.

Numerous studies (e.g., Thomas, Chess & Birch, 1956; Watson & Raynor, 1920) have shown how environment is the supreme force in development and how adults can mold children’s behavior without the use of pharmaceuticals. Beyond the drugs being administered to the mouths of babes, however, we also need to seriously reconsider if even a small percentage of the millions of children who are four to seventeen should be prescribed such drugs that come with far too many unknowns. I will expand more on the four to seventeen age group in the next part of this blog series.

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References:

Berk, L. E., & Meyers, A. B. (2016). Infants, Children, and Adolescents (8th ed.), New York: Pearson.

Braungart-Rieker, J.M., Hill, A.L., & Karrass, J. (2010). Fear and Anger Reactivity Trajectories From 4 to 16 Months: The Effects of Temperament, Regulation, and Maternal Sensitivity, Developmental Psychology, 46, 791-804.:

Corrigan, M. W. (March, 2014). Debunking ADHD: 10 Reasons to Stop Drugging Kids for Acting Like Kids, NewYork: Rowman and Littlefield

Menyuk, P.,  Liebergott, J., & Schultz, M. (1995). Early language development in full-term and premature infants. Hillsdale, N.J: Lawrence Erlbaum Associates.

Santrock, J. W. (2016). Essentials of Life-Span Development (4th ed.), New York: McGrawHill.

13 COMMENTS

  1. So much so well said in this blog . And so painful to read . As if only a victorious full scale war against the pharmaceutical drug cartel and psychiatry could bring satisfaction . And yet there is so much more wrong. How could we the people have grown so asleep to allow these pigs to tamper with our children ?

  2. Great article!

    In our efforts to mold our kids (and now grandkids) we tend to want to protect them from failure. Forgetting that failure is only feedback to which we grow and learn from.

    “natural child development process” is the key here.

  3. I like your research into the past. There were times when children were honored brief as those were. I would recommend Fritz Redl’s work, Clark Moutaskas sp?,Selma Friaberg, Peter Blos, D W Winnicot, as some folks who at least tried to honor children and their lives. Sue they may have been imperfect but alot better than just using drugs as treatment for the wide range of behaviors exhibited by children.
    Also Trauam theory and the work of Alice Miller also needs to be re -explored. Potentially all in my family could qualify for one of several of the ADHD terms. Some of my children as they got older chose by themselves to go on medication. One was on and then came off.
    I started Ritalin when I went back to school to change careers. It was the biggest mistake off my life. I developed anxiety and it just went on from there. Those few months of feel good and weight loss and looking good and feeling smart led to 13 years of being in the system where I was almost sent to long term care.
    Maria Montessori first worked with children from the urban area of Rome, Italy. She was very strong in her conviction that environment was primary in children’s behavior.

    I am sure she is turning in her grave today as unknowing parents med up their kids before going to school. Something is so wrong here!

  4. I totally agree, drugs mask reality / problems, rather than helping. I volunteer with a group of underprivileged children once a week. One child I have been working with for about a year and a half was likely medicated this year. He was always very good about concentrating and doing his work, but he was being bullied by other children. He was drugged, I was told. Now he’s almost unmanageable, according to others, and I know he is now regularly taken out of the program.

    Today, he did half of the work given to him, he had no homework, and when I asked him to do the other half of what was given to him to work on, he went somewhat “mental” on me. Rather than doing what I asked, he frowned incessantly and chose to turn the page into a paper airplane. I ended up encouraging this, however.

    And responded by saying, this isn’t your homework, and boys must be boys. Let me walk with you, so you don’t get into trouble, to a safe area so we may safely see how this airplane flies. The directors of the program were concerned due to his “mental” attitude as we did this. But he flew his airplane numerous times as we walked to the other end of the room, and was happy to do so.

    We got to the other end of the room. I run an art program for this child care program, and shared with him what we’d be doing later. He ended up coming over when it was time for art, finishing the project, and loving it. Children shouldn’t be drugged because they’re being bullied, and not all children respond well to programs expecting children to behave as if they’re in the military.

    We really do need to stop drugging children and people for being nonconformists. Our society grows, changes, and improves, due to the brilliance of the unique perspectives of all of humanity. We, as a society, need to start respecting all within, especially the psychiatric industry.

    • Someone Else

      Thank you for posting this. This boy is lucky to have you there in that program. You were there for him when he really needed someone who would actually listen to, not only what he said in his words, but what he said with all the other parts of his unique being.

      • Thanks, Stephen. Yes, I’m worried about him, but others are reactive because I understand he’s come in with a knife and turned over tables – but this is all since he’s been medicated. To me, it’s obvious he doesn’t react well to the drugs, and I didn’t think he needed them initially. But I’m not privy to his entire familial situation.

        I believe children, and all people, need love, acceptance, and advocates – not stigmatization and drugs – when trying to deal with the injustices or frustrations in life. To me the psychiatric theology is basically the exact opposite of how to actually help a person in distress.

  5. As an adult, diagnosed recently with ADHD – Inattentive, I have very mixed feelings about the polarised views that are expressed so loudly by professionals on either side of this debate.

    My instant reaction is to want to respond with unkind words and to make unpleasant suggestions about which orifice I’d like the author to shove his mythical doodoo arguments, but I’ve recently taken my methylphenidate so I’m able to resist temptation right now…. 😉

    What I would say is that I am glad of the recent changes to DSM-V which allow for diagnosis to be made for symptoms dating back to before age 12, instead of the previous requirement at age 7. I had a delicious childhood, spent climbing trees, racing round on rollerskates, and learning in a progressive school environment where there were very few circumstances in which it would have been possible to recognise inattention in any child, due to the buzz of activity all day long. I would love every child to have elements of my own childhood experience. to enable them to develop without recourse to medication as far as possible.

    Beyond the age of 12 though, I remember a slow creep towards a life of struggle, that I now recognise as being largely related to ADHD symptoms. Whilst I don’t consider medication to be the whole or even the major part of my own treatment, I would not want to spray excrement over any sensible assessment of a young person’s struggle with ADHD symptoms.

    As an adult, I view my medication as being a source of relief and help that is enabling me to engage happily with activities that are meaningful to me. My medication use is all about me and my decision to take the medication is mine alone to make. My concern around prescribing medication to children is that it is more difficult to judge whether the medication is always of benefit to the child, or whether it is being used (and possibly mis-used) to bring benefit to the adults struggling to manage the child’s behaviour alongside the usual stresses of life.

    I am hoping that, as time goes on, those of us who identify with an ADHD diagnosis will begin to speak out more loudly about our personal experiences so that we make ourselves heard over the rhetoric being blared from loudspeakers by professionals who themselves have little experience of living with ADHD symptoms. And then, I hope that we adults will all learn to find ways to put a sock in our own mouths while we listen carefully to what children and young people with ADHD diagnoses have to say as they make their way through child services and into adulthood.

    For the record, I was very anti-psychiatry and very much opposed to taking drugs of any kind before I began to explore my own ADHD hypothesis. I was terrified of losing my sense of self and becoming someone I didn’t recognise, if I started the medication. Bless me, I severely over-estimated how these things work! I don’t feel any different at all after taking them and (sadly) they don’t massively change my experience of my symptoms. I still experience the full range of creative and emotional expression that I had before I commenced medication. I am still absolutely and recognisably me. I just have my shit together a little bit better than before and I get more enjoyment out of life now that I am more able to focus better on activities that are important to me.

    I know that not everyone has the same experience of taking medication, but I believe that mine is valid. I am more than a number, and I am more than a product of mythic and doodoo.

    • Thank you for your response.

      I believe that you point out one of the most important things in this discussion/debate or whatever, and that is that you yourself, as an adult, have the choice to take or not take the drugs. Children have no such choice, and often, when parents are not so in love with the idea of their children taking drugs, they are threatened by child services etc. that they just might have their children taken away from them and placed in foster care if they don’t go along with the drugging. Children in foster care are drugged to the gills and made into absolute zombies, all through no choice of their own. Children have no choice about the drugs and very often, if parents are not as compliant as some of the authorities believe that they should be, they also have no choice about the drugs that are forced on their children. I believe that this is a problem. Children cannot give true informed consent to take the drugs and very often their parents are not able to give true informed consent to have their children drugged.

      Yes, you make another valid point when you say that your experience is valid for you. Although I do not believe in any of the psychiatric drugs and do not take them myself I don’t expect anyone else to tow the line and make my decision their decision. You are unique and your experience is valid. All of us need to find some common ground upon which to camp for awhile with one another. Thanks for posting.

      • “Children have no such choice, and often, when parents are not so in love with the idea of their children taking drugs, they are threatened by child services etc. that they just might have their children taken away from them and placed in foster care if they don’t go along with the drugging. Children in foster care are drugged to the gills and made into absolute zombies, all through no choice of their own. ”

        I think we must come from very different cultures. My impression is that requests for add assessments of pre-schoolers is very much parent-driven, and considered unusual in the UK. Child protective services are generally overwhelmed with complex cases and I have never heard of adherence to adhd meds being used as a threat in custody hearings.

        Generally, I think adhd is still quite stigmatized here and the major danger I see is that parents may sometimes chase a diagnosis by way of validating their own parenting, and locating the problems inside the child, before trying different non-medical approaches first, or at least, alongside the meds.

  6. I think it is paramount for parents not to allow psychiatry and pharmaceutical companies to brain damage their children, their toddlers, and their infants. In spite of how alternatives are disparaged by psych-pharma and other medical orthodoxies protecting their bottom line…….. If you feel you need real help that will not harm your child don’t let anything you hear from anywhere or anyone keep you from studying deeply what is offered at http://www.GenerationRescue.org and also http://www.MercuryJustice.org

  7. Drugging kids under 3?!? Do we have to justify why this is evil? I don’t have kids yet but have many friends who have kids exactly in this age group and it’s remarkable not only how exhausting caring for them can be but also how different the development of each of them is. Kids of this age are supposed to be mental and drive you mental, and it’s not being made easier by the artificial closed environments of cities most of us live in where kids are literally climbing walls in small apartments. It’s freaking natural.